N.Y. Insurance Law Section 3234
Pre-existing condition provisions in group and blanket disability policies

(a)

Every group or blanket policy issued or issued for delivery in this state which provides benefits by reason of the disability of the insured and which includes a pre-existing condition provision shall contain in substance the following provision or provisions which in the opinion of the superintendent are more favorable to the members of the group:

(1)

In determining whether a pre-existing condition provision applies to an eligible person, the group or blanket disability policy shall credit the time the person was previously covered under a previous group or blanket disability insurance plan or policy or employer-provided disability benefit arrangement, if the previous coverage was continuous to a date not more than sixty days prior to the effective date of the new coverage. The credit shall apply to the extent that the previous coverage or level of benefits was substantially similar to the new coverage or level of benefits; and

(2)

No pre-existing condition provision shall exclude coverage for a period in excess of twelve months following the effective date of coverage for the covered person.

(b)

Nothing herein shall be construed to prohibit or restrict an insurer from utilizing other forms of underwriting for the members of the group in lieu of, or in addition to, the pre-existing condition provision described in subsection (a) of this section. * NB There are 2 § 3234’s

Source: Section 3234 — Pre-existing condition provisions in group and blanket disability policies, https://www.­nysenate.­gov/legislation/laws/ISC/3234 (updated Dec. 24, 2021; accessed Apr. 13, 2024).

3201
Approval of life, accident and health, credit unemployment, and annuity policy forms 3202
Withdrawal of approval of policy forms 3203
Individual life insurance policies 3204
Policy to contain entire contract 3205
Insurable interest in the person 3206
Policies which provide for an adjustable maximum rate of interest on policy loans 3207
Life insurance contracts by or for the benefit of minors 3208
Antedating of life insurance policies and burial agreements prohibited 3209
Life insurance, annuities and funding agreements disclosure requirements 3210
Incontestability after reinstatement 3211
Notice of premium due under life or disability insurance policy 3212
Exemption of proceeds and avails of certain insurance and annuity contracts 3213
Payment of proceeds 3214
Interest upon proceeds of life insurance policies and annuity contracts 3215
Disability benefits in connection with life insurance and annuities 3216
Individual accident and health insurance policy provisions 3217
Minimum standards in the form, content and sale of accident and health insurance 3217–A
Disclosure of information 3217–B
Prohibitions 3217–C
Primary and preventive obstetric and gynecologic care 3217–D
Grievance procedure and access to specialty care 3217–E
Choice of health care provider 3217–F
Prohibition on lifetime and annual limits 3217–G
Maternal depression screenings 3217–H
Telehealth delivery of services 3217–I
Essential health benefits package and limit on cost-sharing 3217–J
Utilization review determinations for medically fragile children 3218
Medicare supplemental insurance policies 3219
Annuity and pure endowment contracts and certain group annuity certificates 3220
Group life insurance policies 3221
Group or blanket accident and health insurance policies 3222
Funding agreements 3223
Group annuity contracts 3224
Standard claim forms 3224–A
Standards for prompt, fair and equitable settlement of claims for health care and payments for health care services 3224–B
Rules relating to the processing of health claims and overpayments to physicians 3224–C
Coordination of benefits 3224–D
Prescription synchronization 3225
Eligibility for health insurance in cases of exposure to DES 3226
Reinsurance contracts excepted 3227
Interest upon surrenders, policy loans and other funds 3228
Individual accident and health insurance policies 3229
Minimum benefit standards for certain long term care plans 3230
Accelerated payment of the death benefit or special surrender value under a life insurance policy 3231
Rating of individual and small group health insurance policies 3231*2
Health insurance policies and subscriber contracts 3232
Pre-existing condition provisions in health policies 3232–A
Certification of creditable coverage 3233
Stabilization of health insurance markets and premium rates 3234
Pre-existing condition provisions in group and blanket disability policies 3234*2
Limitations on administrative services and stop-loss coverage 3235
Explanation of benefits forms relating to claims under medicare supplemental insurance policies and limited benefits health insurance pol... 3236
Public health law assessments 3237
Health insurance coverage for full-time students on medical leaves of absence 3238
Pre-authorization of health care services 3239
Wellness programs 3240
Unclaimed benefits 3240*2
Student accident and health insurance 3241
Network coverage 3242
Prescription drug coverage 3243
Discrimination because of sex or marital status in hospital, surgical or medical expense insurance 3244
Explanation of benefits forms relating to claims under certain accident and health insurance policies 3245
Liability to providers in the event of an insolvency
Green check means up to date. Up to date

Accessed:
Apr. 13, 2024

Last modified:
Dec. 24, 2021

§ 3234’s source at nysenate​.gov

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